Employee Guidance for Employees with High Medical Risk during a H1N1 Outbreak

The data on who is most at risk for H1N1 continues to evolve. Early studies have helped identify risk groups and to guide vaccination, prevention and workforce recommendations.

Groups at higher risk for H1N1 Influenza complications include:

• Children younger than 2 years old
• Adults 65 years of age or older
• Pregnant women
• Persons with the following conditions:
  • Chronic pulmonary (including asthma), cardiovascular (except hypertension), Kidney, Liver and blood disorders (including sickle cell disease), or metabolic diseases such as diabetes mellitus;
  • Disorders that that impair respiratory function or the handling of respiratory secretions or that can increase the risk for aspiration (e.g., cognitive dysfunction, spinal cord injuries, seizure disorders, or other neuromuscular disorders);
  • Conditions that suppress the immune system, including but not limited to suppression caused by medications or by HIV;
  • Persons younger than 19 years of age who are receiving long-term aspirin therapy, because of an increased risk for Reye syndrome.

Vaccine Recommendations

The CDC is currently recommending that the following groups receive priority for vaccine for H1N1 when it becomes available.

• pregnant women
• persons who live with or provide care for infants aged less than 6 months (e.g., parents, siblings, and daycare providers)
• health-care and emergency medical services personnel who have direct contact with patients or infectious material,
• children aged 6 months - 4 years, and
• children and adolescents aged 5 - 18 years who have medical conditions that put them at higher risk for influenza-related complications.

Prevention Measures

• Get your seasonal influenza (different from H1N1) shot
• Cover your mouth when coughing with disposables tissue or cough into your upper arm
• Wash your hands often using soap for at least 15-20 seconds, especially after coughing or touching drainage from your nose, or after shaking hands
• Alcohol-based hand cleaners are also effective
• If soap and water are not available and alcohol-based products are not allowed, other hand sanitizers that do not contain alcohol may be useful for cleaning hands. However, they may not be as effective as alcohol-based sanitizers

Work Force Recommendations

• Sick or ill employees should not come to work. Employees with influenza like illness (ILI) should go and stay home until they are free of fever (100 degrees F [37.8 degrees C] or greater), or signs of a fever (chills, feel very warm, flushed appearance, or sweating), without the use of fever-reducing medications (any medicine that contains ibuprofen or acetaminophen) for at least 24 hours. For information about how supervisors can manage employees who have known or suspected ILI, please visit http://www.dhs.gov/files/programs/gc_1250277995953.shtm#1
• Persons with suspected influenza type infection or anyone displaying symptoms of influenza type infection should be considered contagious until at least 24 hours after they no longer have a fever as described above.
• Employees who are well but who have an ill family member at home with influenza can go to work as usual. However, these employees should monitor their health every day, and stay home if they become ill.
• Persons who have severe illness or who have influenza like illness and are at high risk for flu complications should contact their health care provider or seek medical care. Your health care provider will determine whether flu testing or treatment is needed.
• In the event that a medically high risk (see above definition) employee is exposed to someone with suspected influenza type illness (i.e., within 3 feet of a person suspected influenza illness and who is not wearing a mask), the employee should contact their medical provider for possible evaluation and may also contact their Occupational Safety and Health manager for workplace exposure guidance
• If you would like to request a reasonable accommodation due to a disability, please contact your EEO office.

Warning Signs Requiring Immediate Medical Care

If you experience any of the following warning signs, or other concerning symptoms, you should seek emergency medical care:

• difficulty breathing
• unable to take adequate fluids
• confusion or altered mental status; severe headache or other pain that is clearly not controlled by usual medications; sudden weakness, or change in vision
• rapid worsening of symptoms

Employees at high-risk of complications of H1N1 who wish to request modification to their work arrangement should discuss it first with their immediate supervisor. If needed, supervisors may obtain additional information from their servicing Human Capital Office's Employee Relations Office. In the case of a disability accommodation, employees should contact their component's EEO Office's Disability Program Manager, or in the case of Headquarters support components, Kathleen Lane at kathleen.lane@dhs.gov.

This document provides general guidance only for employees covered by Title 5, United States Code, and does not, and is not intended to create or violate any legal rights.